NCCN Research & Business Resources

Patient and Payment Assistance

The oncology reimbursement landscape continues to present ever-evolving challenges for clinicians and others that work with patients with cancer. As a response to these ongoing challenges, help is available through the NCCN Virtual Reimbursement Resource Room.

Select a cancer or supportive care indication or select a reimbursement program below to learn about reimbursement help and services available to you to help your practice mitigate reimbursement challenges.

The NCCN Reimbursement Resource FREE App for Smartphones and Tablets

Now available for Apple and Android
smartphones and tablets! As a response to these ongoing challenges, help is available through the NCCN Reimbursement Resource App; users are able
to search for available resources and payment
assistance programs.

Information on resources available are listed under three different tabs entitled: Search by Cancer Type or Supportive Care Indication, Search by Drug Name (brand or generic), and Search by Reimbursement or Assistance Program.

The NCCN Virtual Reimbursement Resource Guide

A printer-friendly 23 page resource to empower patients with cancer and their caregivers as you help them navigate the challenging reimbursement landscape.

XTANDI Support Solutions℠ is designed as a single point of contact to help patients and their loved ones understand their coverage and reimbursement options for XTANDI (enzalutamide) capsules. Astellas is firmly committed to ensuring our patients have access to XTANDI, regardless of their financial status. We are here to answer questions about your insurance coverage and options for filling your prescription in order to get you started on therapy as quickly as possible.

Flexible and integrated resources for patient access and support:

Covers the needs of patients with private insurance and Medicare, as well as uninsured patients

Physicians can send a prescription directly to a Specialty Pharmacy Provider in the network, HUB call center, or self-dispense out of an office based pharmacy

Provides patient benefit verification and support with prior authorization and appeals assistance

XTANDI Patient Savings Program℠

Co-pay assistance for privately insured patients

One time enrollment per year or 12 monthly refills

Patients pay no more than $20.00/month with an annual maximum benefit of up to $12,000/year

Quick Start+℠ for XTANDI
To enable rapid initiation of treatment, the Quick Start+™ program for XTANDI provides a one-time, 14-day gratis fill supply of XTANDI that requires a physician prescription. Quick Start+ is intended for new patients who have not received a coverage decision from their payer (for example, a benefit verification or prior authorization is pending) in time to start therapy in 10 business days. Quick Start+™ offers several benefits:

Allow patients to start treatment with XTANDI while XTANDI Support Solutions℠ troubleshoots issues

Provides quick delivery time so patients can start therapy as soon as possible

Offers direct-to-patient shipping

Astellas Access Program℠
Astellas is committed to supporting and maintaining access to medications for patients who are treated with an Astellas product.

The Astellas Access Program℠ for XTANDI is designed for patients who have no health insurance. This program provides free XTANDI to patients who qualify for enrollment based on insurance and household income status. Eligibility is determined on a patient-specific basis. XTANDI Support Solutions℠ can quickly determine whether a patient is eligible for enrollment.

If you need assistance with the Astellas eService site, XTANDI Support Solutions℠ or have any questions on coding, coverage, and reimbursement for Astellas products, please contact us between the hours of 9:00 AM and 8:00 PM ET Monday through Friday.

Medicare and most private insurance carriers cover the Oncotype DX Breast Recurrence Score test for eligible patients with early-stage invasive breast cancer. In addition, Genomic Health created the Genomic Access Program (GAP) to help patients navigate the insurance and other payment options for Oncotype DX tests. Through GAP, Genomic Health takes every possible step to ensure testing is affordable, available, and accessible. To learn more about GAP, contact Customer Service by phone 866-ONCOTYPE (866-662-6897) or by email at customerservice@genomichealth.com.

IncyteCARES (Connecting to Access, Reimbursement, Education and Support) was established by Incyte to assist providers, patients, and caregivers through a single point of contact with reimbursement assistance, patient access, and distribution coordination for Jakafi® (ruxolitinib).

IncyteCARES assists healthcare professionals and eligible patients with product access through a suite of services, including:

Janssen CarePath is your one source for resources focused on access, affordability, and treatment support for your patients. Our dedicated Care Coordinator team supports all the Janssen medications you prescribe. We can help make it easier for your patients and you to get the resources you both may need.

For DARZALEX®, YONDELIS®, and SYLVANT®, eligible patients pay $5 per infusion with a $20,000 maximum program benefit
per calendar year. The program does not cover cost to give patients their treatment

For ERLEADA™, eligible patients pay $10 per month with a $15,000 maximum program benefit per calendar year or one-year
supply, whichever comes first

For ZYTIGA®, eligible patients pay $10 per month with a $12,000 maximum program benefit per calendar year or one-year
supply, whichever comes first

Patients using Medicare, Medicaid, or other government-funded programs to pay for their medications are not eligible to
participate. Terms expire at the end of each calendar year and may change. There is no income requirement. See JanssenCarePath.com for full eligibility requirements

Treatment support to help your patients get informed and stay on prescribed treatment
Janssen CarePath helps keep your patients informed about their condition and the importance of staying on treatment with:

Education tools

Patient education brochures

Web-based resources

Assistance with identifying independent organizations which may provide assistance with costs associated with travel to and from treatment (not available for all Janssen products)

Access to nurses who can answer patients' questions about treatment with ERLEADA™†

* Independent co-pay assistance foundations have their own rules for eligibility. We have no control over these independent foundations and can only refer your patients to a foundation that supports their disease state. We do not endorse any particular foundation.

† The nurse program is limited to education for patients about their Janssen therapy, its administration, and/or their disease, and is not intended to provide medical advice, replace a treatment plan from the patient's doctor or nurse, or provide case management services.

Patient support
LIBTAYO Surround offers patient support that facilitates access to medication when patients need assistance with out-of-pocket costs, including:

The LIBTAYO Surround Copay Program

Eligible commercially insured patients may pay $0 out-of-pocket for LIBTAYO, with an annual maximum benefit of up to $25,000. Restrictions apply.

The LIBTAYO Surround patient assistance program (PAP)

Eligible patients who are uninsured, lack coverage for LIBTAYO, or have Medicare Part B with no supplemental insurance coverage may receive LIBTAYO at no cost. Restrictions apply.

Assistance finding alternate sources of coverage

Access and reimbursement support
LIBTAYO Surround provides assistance with the reimbursement process, including:

Benefits verifications

Prior authorization and appeals support, as well as claims assistance

Support tools, such as a sample appeal letter and sample letters of medical exception and medical necessity

Product support
LIBTAYO Surround provides support with product ordering.

LIBTAYO Surround is committed to providing reimbursement and access support, as well as financial support for your eligible patients. Visit LIBTAYOhcp.com for more information about this program, or call 1-877-LIBTAYO (1-877-542-8296) Option 1, Monday–Friday, 8 AM–8 PM Eastern time.

The Lilly PatientOne program is committed to helping eligible patients access support programs for Lilly Oncology products they are prescribed. It aims to address both financial and coverage issues for qualified uninsured, underinsured, and insured patients who are prescribed a Lilly Oncology product. PatientOne strives to offer resources, ranging from benefits investigations to financial assistance and appeals information, that provide reliable and individualized treatment support for eligible patients.

Services offered by this program include:

Insurance expertise

Coding and billing information

Payment methodologies and allowables

Payer policy information

Patient Assistance Program

Drug replacement for eligible patients

Financial assistance

Information about co-pay assistance foundations

Co-pay program to assist eligible patients with out-of-pocket costs for specific Lilly
Oncology products where available

Enrollment
AZEDRA Service Connection is a complimentary program and provides a simple enrollment process for patients.

Patient Access Specialists
Our team of specialists will help you order AZEDRA and provide one-on-one phone assistance on matters such as out-of-pocket and reimbursement assistance to patients who are prescribed AZEDRA and their caregivers. Patient Access Specialists also connect patients to independent, third-party organizations for support*, including help finding transportation and lodging assistance.*†

*Provided through independent third-party foundations (501(c)(3), tax-exempt nonprofit organizations). AZEDRA Service Connection Program has no control over independent, third-party programs and provides connections as a courtesy only.

Novartis Oncology is committed to helping patients living with cancer receive the medicines they need. Patient Assistance Now Oncology (PANO) offers quick and easy access to information about the broad array of support and reimbursement programs available.

You can get information about our PANO support programs in 2 ways:

Call 1-800-282-7630 to speak with a member of our knowledgeable staff dedicated to making access to our programs as simple and convenient as possible; or

The Patient Access Network (PAN) Foundation is an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic and rare diseases with the out-of-pocket costs for their prescribed medications. Partnering with generous donors, healthcare providers and pharmacies, PAN provides the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life. Since its founding in 2004, PAN has provided nearly 1 million underinsured patients with over $3 billion in financial assistance, through over 60 disease-specific programs. For more information please visit http://www.PANFoundation.org or call 1.866.316.7263.

Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise) offers reimbursement support for branded Teva Oncology products. Some of the options include benefit verification, prior authorization support and customer service through the claims and appeals process. CORE also provides referrals to the Teva Cares patient assistance program.

For more information or an introductory consult please call 1-888-587-3263 or visit www.TevaCore.com

Personalized assistance for IMBRUVICA® (ibrutinib) patients to help them:

Learn about access to IMBRUVICA®

Understand affordability support options

Sign up for information and resources to support them along their treatment journey

Access Support
We can help patients learn about access to IMBRUVICA® through:

Rapid benefits investigation

Information on the prior authorization process

Navigating the exception and appeals process

Coordinating IMBRUVICA® delivery

Affordability Support
Regardless of insurance type, we can help your patients understand their options

YOU&i™ Instant Savings Program: Eligible commercial patients pay no more than $10 per month* for IMBRUVICA®

* Month refers to a 30-day supply subject to maximum benefit based on 12 monthly fills. Eligible patients may qualify for instant savings on their commercial insurance co-pay, deductible, and coinsurance medication costs for IMBRUVICA®. Not valid for federal and state healthcare program beneficiaries. Not valid for patients enrolled in Medicare or Medicaid

Independent Foundations: If your patients need additional financial support, we can provide them with information on independent foundations

Other Resources:

Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is committed to providing access to medicines for uninsured individuals who lack the financial resources to pay for them. If your patients need IMBRUVICA® (ibrutinib) and are uninsured and unable to pay for their medicine, please have them contact a JJPAF program specialist at 1.800.652.6227 from 9:00 AM – 6:00 PM ET, or visit the foundation website at www.jjpaf.org to see if they might qualify for assistance.

Nurse Call Support & Resources
Your patients can talk to YOU&i™ nurses who can answer questions and provide information about IMBRUVICA® and their disease